2020-11-11T14:09:47-06:00 2019-12-31 ERNST & YOUNG US LLP 5 TIMES SQUARE NEW YORK NY 10036 990 2019-01-01 462916938 MONTEFIORE MOUNT VERNON HOSPITAL % EVAN RESNICK MONT 9143498455 12 NORTH SEVENTH AVENUE MOUNT VERNON NY 105502026 COLLEEN M BLYE EXEC V.P. & C.F.O. 7189207602 2020-10-29 true NICOLE M SOKOLOWSKI P01683199 2127733000 108.206.163.59 26308520203165000018 2020-11-11 P 24558E047A149CE0743DDA4F89040DC2FD5B7974 770194AAF055F9EA87E64CA02E08FE540289067F 2019 2021-01-29 14:40:06Z PHILIP O OZUAH MD PHD 111 EAST 210TH STREET BRONX NY 104672401 95080203 false X See Form 990, Schedule O X 2013 NY TO HEAL, TO TEACH, TO DISCOVER AND TO ADVANCE THE HEALTH OF THE COMMUNITIES WE SERVE. 42 41 692 22 0 0 17699475 24616348 69168831 69903995 0 4611 792754 541253 87661060 95066207 600 2500 0 0 53013944 54695814 0 0 0 40820577 42548836 93835121 97247150 -6174061 -2180943 41538527 45354488 64878793 57675349 -23340266 -12320861 MISSION: TO HEAL, TO TEACH, TO DISCOVER AND TO ADVANCE THE HEALTH OF THE COMMUNITIES WE SERVE. VALUES: HUMANITY, INNOVATION, TEAMWORK, DIVERSITY AND EQUITY - OUR VALUES DEFINE OUR PHILOSOPHY OF CARE. THEY SHAPE OUR ACTIONS AND MOTIVATE AND INSPIRE US TO PURSUE EXCELLENCE AND ACHIEVE OUR GOALS. false false 84105627 2500 69903995 Montefiore Mount Vernon Hospital is a 176 bed, community-based teaching hospital that has been serving the medical needs of the community. Montefiore Mount Vernon provides inpatient, critical care and ambulatory services to residents of lower Westchester County. The hospital is part of Montefiore Health System, the University hospital for the Albert Einstein College of Medicine. Montefiore MOUNT VERNON HOSPITAL BEGAN OPERATIONS ON NOVEMBER 6, 2013 as part of the Montefiore Health System. MONTEFIORE MOUNT VERNON'S MISSION IS TO HEAL, TO TEACH, TO DISCOVER AND TO ADVANCE THE HEALTH OF THE COMMUNITIES IT SERVES. To this mission, the health system brings a unique synergy of strengths and resources that has helped define healthcare delivery in the area and have earned Mount Vernon the distinction of being a designated New York stroke and HIV/aids Center. Mount Vernon hospital is also home to the Beale Chronic Wound treatment and hyperbaric center and the Montefiore School of Nursing. The hospital provides a range of diagnostic and therapeutic medical and surgical services in addition to specialty programs and services. It operates a family health and wellness center with more than 20 specialized ambulatory care clinics as well as an inpatient and outpatient behavioral health program offering psychiatric services. The hospital also operates a chronic wound treatment and hyperbaric medicine center that offers advance wound management as well as hyperbaric oxygen therapy helping to reduce the risk of amputation for individuals suffering from traumatic injuries. Montefiore Mount Vernon Hospital also operates a drug and alcohol addiction rehabilitation facility located in close proximity to their main campus committed to helping those addicted in getting the treatment that they need. The center offers personalized treatment program specifically designed for the patient including group counseling, 12-step programs, medically assisted detoxification, and individual counseling, among others, that can help to give our patients the confidence that is needed to successfully overcome their addiction to drugs or alcohol. 84105627 true false false true false false false false false false true false false true true false false true false false false false false false false false true true false false true false false false false false false false false false false false false false true true true false false true 11 0 true 692 true false false false false false false false false false false false false X 42 41 false false false false true true true true true false false true true true true true true false false false NY X EVAN RESNICK 9143498455 555 SO BROADWAY BLDG A FL 1 TARRYTOWN NY 105916301 STEVEN M SAFYER MD CEO (Resigned 11/14/19) 5.0 55.0 X 0 8635569 8197338 PHILIP O OZUAH MD President & CEO (Eff 11/15/19) 5.0 55.0 X X 0 7058335 43570 LYNN RICHMOND Exec VP-CSO(Resigned 11/14/19) 5.0 55.0 X 0 3618743 40261 COLLEEN BLYE EXEC VP & CFO 5.0 55.0 X 0 1815150 710037 SUSAN GREEN-LORENZEN System SENIOR VP-OPERATIONS 5.0 55.0 X 0 2209892 44220 CHRISTOPHER S PANCZNE Assistant Secretary 5.0 55.0 X 0 1270367 26913 Bentley A Ogoke MD Anesthesiologist 50.0 0.0 X 451906 0 32834 BALASA PRASAD MD CHAIRMAN-ANESTHESIA 50.0 0.0 X 474274 0 6800 FRANCIS AGBONKPOLO M ANESTHESIOLOGIST 50.0 0.0 X 416667 0 26849 Jaccel Kouns VP & Exc Director MMV 60.0 0.0 X 0 372223 46137 Nadeem Hussain MD Psychiatrist 50.0 0.0 X 363635 0 26315 Sanford Taffet MD Physician 50.0 0.0 X 332299 0 32236 ODED ABOODI VICE CHAIRMAN & TREASURER 0.3 2.2 X 0 0 0 JAY B ABRAMSON TRUSTEE 0.3 2.2 X 0 0 0 MARGARET HAYES ADAME TRUSTEE (Passed 11/14/19) 0.2 1.55 X 0 0 0 PATRICIA BAUMAN TRUSTEE 0.2 1.05 X 0 0 0 JAMES M BUTLER CHAIRMAN 0.5 4.0 X 0 0 0 BRUCE DONIGER TRUSTEE 0.2 1.05 X 0 0 0 RUTH L GOTTESMAN ED TRUSTEE 0.2 2.05 X 0 0 0 BARRY W GRAY TRUSTEE 0.2 1.05 X 0 0 0 PATRICIA GREEN TRUSTEE 0.2 1.05 X 0 0 0 THOMAS L HARRISON TRUSTEE 0.2 1.05 X 0 0 0 JOHN HEFFER TRUSTEE 0.3 2.2 X 0 0 0 LEWIS HENKIND Trustee 0.2 2.05 X 0 0 0 HELEN A JOHNSON TRUSTEE 0.3 1.7 X 0 0 0 DAVID B KEIDAN TRUSTEE 0.2 1.05 X 0 0 0 ALAN M KLEIN TRUSTEE 0.4 3.1 X 0 0 0 STACEY R LANE TRUSTEE 0.3 2.2 X 0 0 0 JAY B LANGNER TRUSTEE/CHAIRMAN EMERITUS 0.2 1.05 X 0 0 0 MARGARET S NATHAN TRUSTEE 0.2 1.05 X 0 0 0 GAYLE F ROBINSON TRUSTEE 0.2 1.05 X 0 0 0 JON W ROTENSTREICH TRUSTEE 0.2 1.05 X 0 0 0 HON FELICIA K SHEA TRUSTEE 0.2 1.05 X 0 0 0 EDWIN H STERN III TRUSTEE 0.2 1.05 X 0 0 0 DAVID A TANNER TRUSTEE 0.2 1.3 X 0 0 0 CYNTHIA KING VANCE TRUSTEE 0.3 2.2 X 0 0 0 JENNIE EMIL TRUSTEE 0.2 1.05 X 0 0 0 JONATHAN A LIPTON TRUSTEE 0.2 1.3 X 0 0 0 ZITA G ROSENTHAL TRUSTEE 0.2 1.05 X 0 0 0 NATHAN GANTCHER TRUSTEE 0.2 2.3 X 0 0 0 CATHERINE KLEMA TRUSTEE 0.3 2.2 X 0 0 0 MELISSA CERIALE TRUSTEE 0.3 2.2 X 0 0 0 BARRY S BLATTMAN TRUSTEE 0.3 2.2 X 0 0 0 MATTHEW H NORD TRUSTEE 0.2 1.3 X 0 0 0 MICHAEL A STOCKER M TRUSTEE 0.3 3.2 X 0 0 0 ROGER EINIGER TRUSTEE 0.2 2.3 X 0 0 0 JOEL BRAUN TRUSTEE 0.2 1.05 X 0 0 0 EMANUEL CHIRICO TRUSTEE 0.3 1.7 X 0 0 0 W NORMAN MILNER TRUSTEE 0.2 1.05 X 0 0 0 ALISA R DOCTOROFF TRUSTEE 0.2 1.3 X 0 0 0 JOHN P GUTFREUND TRUSTEE 0.2 1.05 X 0 0 0 RONALD L MOELIS TRUSTEE 0.2 1.05 X 0 0 0 Alan N Suna Trustee 0.2 1.05 X 0 0 0 Daniel R Tishman trustee 0.2 3.05 X 0 0 0 2038781 24980279 9233510 108 false true false Excel Emergency Physician Services 484 Temple Hill Road Suite 102 NEW WINDSOR NY 12553 Physician Services 1432825 Century Protective Services Inc 150 Grant Street WHITE PLAINS NY 10601 Security Services 987971 Healogics Wound Care Hyperbaric S 28525 Network place CHICAGO IL 60673 Hyperbaric services 815238 Medicus Psychiatry Services LLC 22 Rouiston Road WINDHAM NH 03087 Psychiatric Services 780277 Radiology Advantage New Jersey PA PO Box 744881 ATLANTA GA 30374 Radiology Services 685095 20 24615848 500 24616348 INPATIENT SERVICES 622000 45894522 45894522 0 0 OUTPATIENT SERVICES 621400 20964278 20964278 0 0 RENTAL INCOME FROM EXEMPT AFFILIATE 531120 1456625 1456625 0 0 OTHER HEALTH CARE SERVICES REVENUE 621999 1068290 1068290 0 0 INTERCOMPANY SHARED SERVICES 561439 360067 360067 0 0 160213 160213 0 0 69903995 4611 0 0 4611 0 0 23126 13996 9130 0 9130 0 0 9130 0 0 0 0 0 0 0 0 0 0 CAFETERIA/COFFEE SHOP & VENDING INCOME 722514 332393 0 0 332393 PARKING INCOME 812930 185340 0 0 185340 MEDICAL RECORD'S COPIES 541900 14112 0 0 14112 278 0 0 278 532123 95066207 69903995 0 545864 2500 2500 0 0 0 0 0 41367075 39673113 1693962 0 2975394 2856530 118864 0 7436097 7139032 297065 0 2917248 2800707 116541 0 111305 111305 0 0 452123 238 451885 0 0 0 0 0 7012950 6954711 58239 0 0 3916978 3813497 103481 0 2633653 2152342 481311 0 0 3740716 2617528 1123188 0 53108 48259 4849 0 0 18625 18131 494 0 709817 709817 0 0 0 1526451 1372125 154326 0 3412048 3301791 110257 0 INTERCOMPANY SHARED SERVICES 9715792 1911515 7804277 0 MEDICAL SUPPLIES 7487370 7476472 10898 0 MEMBERSHIP FEES 1208338 932747 275591 0 BILLING AND COLLECTION 331530 0 331530 0 218032 213267 4765 97247150 84105627 13141523 0 700 700 2957708 6922274 216804 302711 5782995 4820342 0 0 0 0 0 0 1430671 1285825 456304 287208 20020947 9237459 11861345 10783488 0 0 0 0 0 0 0 0 18832000 20951940 41538527 45354488 22098306 17801917 0 0 320168 772692 0 0 0 0 0 0 0 0 0 0 42460319 39100740 64878793 57675349 X -23340266 -12320861 0 0 -23340266 -12320861 41538527 45354488 X -2180943 13200348 X false true X true true true X false false false false false false false false true 7641 7641 false Schedule C, Part II-B, Line 1i THE other activities includes indirect lobbying cost for the organization's pro-rata share of Healthcare Education Project (HEP) Lobbying expenses. 8376457 2217466 6158991 11620727 7019993 4600734 23763 23763 10783488 EST INSURANCE CLAIMS RECEIV 20858000 RIGHT OF USE OPER LEASE ASSETS 93940 20951940 0 LOANS PAYABLE - PARENT 6550000 DUE TO THIRD PARTY PAYORS 2356332 MALPRACTICE INSURANCE LIABILITIES 538536 EST INSURANCE CLAIMS LIABILITIES 20858000 DUE TO AFFILIATES 8617742 PENSION LIABILITIES 84445 RIGHT OF USE OPER LEASE LIAB. 95685 39100740 true true X true X true X 500. true true true false true true 6314108 6084363 229745 0.00240 40367529 22604017 17763513 0.18270 46681637 28688380 17993258 0.18510 496088 0 496088 0.00510 7736653 1385274 6351379 0.06530 8232741 1385274 6847467 0.07040 54914378 30073654 24840725 0.25550 false 227323 5933 11305049 12757949 -1452900 X true true 1 1 Montefiore Mount Vernon Hospital 12 North Seventh Avenue Mount Vernon NY 10550 www.montefiorehealthsystem.org 5903001H X X X X Montefiore Mount Vernon Hospital 1 false false true X X X X X X X X X 19 true true false true X See Part V - Section C X true 19 true See Part V - Section C false true X 100 500. X X true true X X X X true X See Part V - Section C X See Part V - Section C X See Part V - Section C X X X X X X true X false X X X X true X false false Schedule H, PART V, SECTION B, LINE 5 The process for preparing the 2019-2021 Community Health Needs Assessment was an inter-organizational and community collaborative process, initiated with the goal of developing an assessment that was reflective of the needs of the community including the clinical and social determinants of health. The 2019-2021 Community Health Needs Assessment involved a primary data collection strategy in conjunction with secondary data. Community input on health priorities in Westchester County was gathered through a community survey and an in-person summit with stakeholders. Multiple approaches to primary data collection were used to make use of existing and cost-efficient data collection activities and to employ multiple methods at gathering community input, so that no single group was over represented in the identification of community concerns. Montefiore Mount Vernon Hospital engaged with the Westchester County Department of Healths online Community Resident Survey in the winter and spring of 2019 to facilitate the implementation of the primary data collection process for the Community Health Needs Assessment for Westchester County and to assist in the facilitation of these community level connections thereby alleviating additional surveying overload. The community survey could be completed via a web-based tool (SurveyMonkey) or on paper. The paper surveys were available in English and Spanish and other languages by request. The primary distribution of the survey was conducted through the Westchester County Department of Healths Office of the Administrator and was made available through its website. The Montefiore Hudson Valley Collaborative also distributed the survey to its membership of over 900 hospitals, community based organizations, faith-based organizations and other social service providers. The survey was disseminated through multiple distribution points including other hospitals, health care providers, community-based organizations and others. A Community Health Survey of the Hudson Valley was created and administered by Siena College Research Institute on behalf of the CHA Collaborative. The survey was conducted in all seven counties in the region. Additionally, in March and April of 2019, Members of the Local Health Department Prevention Agenda collaborative conducted 10 focus groups with health and service providers to identify the most pressing barriers and issues facing the populations they serve. The Local Health Department Prevention Agenda collaborative designed the focus groups as a supplement to the Community Health Survey acknowledging that certain populations, mainly those who speak English as a second language, those experiencing homelessness, members of the LGBTQ community, and children may have been under represented in the original data collection process. In addition to collaborative input from the local Department of Health, Montefiore worked closely with it communities, organized partnership and collaborates, and other providers in lower Westchester as well as extensive work with representatives of the affected communities to help Montefiore to identify health care needs and determine the appropriate configuration of services. While the exact priorities identified through each of these approaches varied somewhat, there was a consistent placement of healthy eating and food security, and its related environmental factors of access to healthier food and the health consequences of chronic disease care and screening as the top community health priorities. Montefiore Mount Vernon meets regularly with the local Department of Health, and continues to participate in a MHVC DSRIP aligned Collaborative with membership from St. Josephs Medical Center (including St. Vincents Hospital Westchester), St. Johns Riverside Hospital, White Plains Hospital, and Burke Rehabilitation Hospital working to ensure that the Community Service Plan and DSRIP goals retain their alignment. As the CHNA process was conducted simultaneously with the New York State Community Service Plan (CSP) review, there is strong alignment between the areas of focus in this report and the areas presented in the CSP. Montefiore will continue to work with its partners on existing program initiatives in its mission of advancing healthcare to the communities that it serves. The Hospital has not received any written comments concerning it most recent conducted CHNA and implementation strategies. Schedule H, Part V, Section B, Line 6A Montefiore Mount Vernon Hospitals CHNA was conducted along with Montefiore New Rochelle Hospital. The reporting data between the two facilities are essentially the same, even though demographically distinct, due to the close proximity of each facility to the other, the high migration of patients between facilities and the sharing of employees. Both organizations are also members of the Montefiore Health System, the premier academic health system and the University Hospital for Albert Einstein College of Medicine, serving the 3.1 million people living in the New York City region and the Hudson Valley. Schedule H, Part V, Section B, Line 7a The CHNA report is available to the public on Montefiore's website: https://www.montefiore.org/documents/communityservices/MNR-MMV-Community-H ealth-Needs-Report-2019-2021.pdf Schedule H, Part V, Section B, Line 10a The hospital facility's most recently adopted implementation strategy is posted on the website: https://www.montefiore.org/documents/communityservices/MNR-MMV-Community-H ealth-Needs-Report-2019-2021.pdf Schedule H, Part V, Section B, Line 11 In the Comprehensive Community Services plan developed for 2016-2018, the priority areas selected were Prevent Chronic Disease and Promote Healthy Women Infants and Children. Through the projects and activities initiated during that plan, Montefiore Mount Vernon was able to contribute to the overall trend improvements in those areas for New York State. However, although Westchester County has continued to be among the top five and has shown improvements along with the rest of New York State, the rates for conditions identified in the communities of Mount Vernon remains higher in most cases than the countywide and statewide averages. The Priority Areas that were selected in 2016 have been expanded upon to have greater alignment with the initiatives of the Delivery System Reform Incentive Payment Program (DSRIP). Montefiore Mount Vernon choose to continue its work on Maternal and Child Health with an emphasis on breastfeeding. Furthermore, Montefiore Mount Vernon will continue their participation with the Westchester County Department of Healths Community Service Plan Collaborative to coordinate their alignment with the Countys other healthcare providers. Montefiore has elected to retain these two priority areas, Prevent Chronic Disease and Promote Healthy Women Infants and Children for the 2019-2021 plan. Montefiore Mount Vernon Hospital has also added a new priority area for this cycle: Prevent Communicable Disease with a focus on vaccine preventable disease, specifically HPV. The first Priority area selected was preventing chronic Disease with a specific focus on preventive Care and Management. This hospital is addressing this need by providing access to a range of preventive, maintenance and self-management programs for individuals across the pre-diabetes and diabetes spectrum with assistance from our partners in providing technical Assistance, opportunities for neighborhood based culture/linguistic specific classes and opportunities for data sharing and collaboration. Our goal is to increase early detection of cardiovascular disease, diabetes, pre-diabetes and obesity. The targeted community is mainly low-income individuals that includes a high proportion of Hispanic and non-Hispanic black. The second priory area selected was to promote healthy women, infants and children with a focus on perinatal and infant health. The hospital will address this need by engagement and referral into appropriate clinical or community programs to support mothers with breastfeeding. Our partners will also provide technical assistance and supportive community programming. Our goal is to increase the percentage of all infants who are exclusively breastfed in the hospital by 10% from 47.0% to 51.7%. The third and new priority area added for the 2019-2021 plan is to prevent communicable disease focusing on vaccine preventable diseases. We plan to support outreach efforts through education and advocacy of the importance of HPV vaccination with parents of children and adolescents age 9-13 and provide vaccinations with the goal of increasing the percentage of NYS 13-year-old adolescents with a complete HPV vaccine series by 10% to 37.4%. The targeted community is mainly low-income individuals including a large Hispanic or non-Hispanic black population. Despite each of the different methods and approaches to primary data collection in gathering community input, there was a consistent focus on obesity and related behaviors and outcomes among the main community health concerns. Obesity and its related behaviors have significant impact in chronic disease, therefore, it is intended that the programs that are detailed specifically for the reduction of obesity will also affect the prevalence of Diabetes, hypertension, asthma, cancer and cardiovascular disease in Westchester County. Montefiore has a vast portfolio of programs and services that address a majority of the significant community health needs identifies in the community health needs assessment. The breadth and depth of the programs and service vary, but each address a need identifies in the community. In particular, there are programs underway in collaboration with Hudson River Healthcare and Westchester local government units to work with bodegas on healthy snack displays and creating walking paths in parks and communities. In addition to the multiple resources that have been developed at Montefiore independently and through partnership with other organizations, there continues to be a need for community-based programs and resources that can augment Montefiores programs and services. Montefiore continues to engage in cross-sector partnerships with government, community organizations, hospitals, and businesses to address the health and social needs of our patient population. Since the previous version of this report in 2016, Montefiore has begun using the internet database platform www.nowpow.com, to connect patients to needed resources, which has been a challenge for the health care sector. This online tool is a much more comprehensive and practical alternative to the homegrown referral guides that many health care providers have had to use in the past, which were difficult to search and keep-up-to-date, a problem that is largely addressed by the online version. Many Montefiore sites have been introduced to this new online resource and work is underway to more seamlessly integrate this kind of solution into the various workflows across the ambulatory, ED and inpatient setting. The use of an internet database will allow Montefiore to connect patients to important community resources provided outside of the health system by many of our community partners to address community needs such as housing (quality and affordability), transportation, employment, and education. Montefiore recognizes the importance of addressing the social determinants of Health as part of our mission of advancing the health of the communities that we serve. Schedule H, Part V, Section B, Line 13H Family size is factored into the eligibility criteria for financial assistance. Schedule H, Part V, Section B, Line 15E The organization's FAP provides addresses, locations and phone numbers for offices within Montefiore to assist with completing applications. The financial aid and Medicaid staff at these locations are also certified application counselors that assist with market place and Medicaid applications. Schedule H, Part V, Section B, Lines 16a-16c The direct website where the FAP is publicized: http://www.montefiorehealthsystem.org/body.cfm?id=68 2 MONTEFIORE MT VERNON METHADONE PROGRAM 3 SOUTH SIXTH AVENUE MOUNT VERNON NY 10550 SUBSTANCE ABUSE EXTENSION CLINIC MONTEFIORE MT VERNON HOSP ACT PROGRAM 3 SOUTH SIXTH AVENUE MOUNT VERNON NY 10550 MENTAL HEALTH CLINIC 1. REQUIRED DESCRIPTIONS: PART I, LINE 7: THE COST-TO-CHARGE RATIO METHODOLOGY WAS UTILIZED TO CALCULATE THE AMOUNT INCLUDED IN THE TABLE. THE CALCULATION OF THIS RATIO WAS DERIVED FROM RATIO OF PATIENT CARE COSTS-TO-CHARGES. PART III, SECTION A, LINE 2: THE COST OF BAD DEBT EXPENSE WAS ESTIMATED BASED ON THE CHARGES, APPLIED TO THE RATIO OF TOTAL PATIENT CARE EXPENSES TO TOTAL CHARGES FOR ALL SERVICES RENDERED. ANY PAYMENTS OR DISCOUNTS ARE EXCLUDED FROM BAD DEBT EXPENSE. PART III, SECTION A, LINE 3: THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE (AT COST) ATTRIBUTED TO PATIENTS UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS BASED ON RESULTS OF PREDICTIVE ANALYSIS. BAD DEBT SHOULD BE INCLUDED AS A COMMUNITY BENEFIT BECAUSE THE ORGANIZATION PROVIDES MUCH NEEDED HEALTH CARE SERVICES INDISCRIMINATELY TO THE COMMUNITY-AT-LARGE WITHOUT REGARD TO WHETHER OR NOT THE PATIENT HAS INSURANCE AND IF THE BILL WILL EVER BE PAID. PART III, SECTION A, LINE 4: AS REPORTED IN MONTEFIORE HEALTH SYSTEM'S AUDITED CONSOLIDATED FINANCIAL STATEMENTS, BAD DEBT EXPENSE IS DESCRIBED AS FOLLOWS: "Subsequent changes to the estimate of the transaction price (determined on a portfolio basis when applicable) are generally recorded as adjustments to patient service revenue in the period of the change. For the years ended December 31, 2019 and 2018, changes in the Health Systems estimates of expected payments for performance obligations satisfied in prior years were not significant. Portfolio collection estimates are updated based on collection trends. Subsequent changes that are determined to be the result of an adverse change in the patients ability to pay (determined on a portfolio basis when applicable) are recorded as bad debt expense. Bad debt expense for the years ended December 31, 2019 and 2018 was not significant". PART III, SECTON B, LINE 8: MEDICARE REVENUE AND ALLOWABLE COSTS REPORTED IN PART III, SECTION B, were derived FROM THE MEDICARE COST REPORT. MEDICARE ALLOWABLE COSTS REPORTED on PART III, LINE 6, PER SCHEDULE H INSTRUCTIONS, WERE DERIVED USING THE Medicare COST REPORT COST-FINDING METHODOLOGY, WHICH APPORTIONS ROUTINE costs TO MEDICARE USING DAYS AND ANCILLARY COSTS TO MEDICARE USING departmental RATIOS OF COSTS TO CHARGES. THE FOLLOWING TABLE REPRESENTS a reconciliation OF MEDICARE REVENUE AND COSTS INCLUDED ON LINES 5, 6, AND 7 IN PART III TO THE TOTAL ACTUAL MEDICARE REVENUE AND COSTS OF THE Hospital. AS HIGHLIGHTED IN THIS TABLE, INCLUDING THE ADJUSTMENTS described BELOW WOULD HAVE increased the MEDICARE Shortfall to $4,353,946. ALLOWABLE Surplus/ Revenue costs (Shortfall) PART III, LINE 5-7: $11,305,049 $12,757,949 ($1,452,900) ADD: Cost not included: 1,418,303 (1,418,303) ADD: MEDICARE DME: 275,458 1,758,201 (1,482,743) Adjusted MEDICARE Shortfall: $11,580,507 $15,934,453 ($4,353,946) PART III, SECTION C, LINE 9B: FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE, ALL COLLECTION ACTIVITY IS HALTED AND THE PATIENT IS REFERRED FOR FINANCIAL AID. IF AN ACCOUNT IS IN COLLECTION AND THE PATIENT REQUESTS FINANCIAL AID OR IF THE AGENCY DETERMINES THAT THE PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE, THE ACCOUNT IS REFERRED BACK TO THE HOSPITAL WHERE THE PATIENT IS PROVIDED ASSISTANCE WITH COMPLETING AN APPLICATION FOR ASSISTANCE. 2. NEEDS ASSESSMENT: In addition to collaborative input from the local Department of Health and clinical partners, Montefiore works closely with its communities including the Mount Vernon Community Advisory Board (MVCAB). Working with a variety of organized partnerships and collaboratives and other providers in lower Westchester as well as extensive work with representatives of the affected communities has helped Montefiore to identify health care needs and determine the appropriate configuration of services. Beyond the formal structures that Montefiore established to gain input from the communities it serves, Montefiores Office of Community and Population Health participates in a variety of informal organized partnerships and collaboratives, working with other providers in the Westchester, the Westchester County Department of Health, community-based organizations and others, using a community level approach that involves relevant community based organizations interested in planning and developing initiatives aimed at improving the health of the residents of Westchester County. 3. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: ALL INTAKE, REGISTRATION, AND COLLECTION AGENCY STAFF IS TRAINED ON THE HOSPITAL'S FINANCIAL AID POLICY AND HOW TO PROVIDE PATIENTS WITH ASSISTANCE. MONTEFIORE MOUNT VERNON HOSPITAL HAS A POLICY THAT ESTABLISHES GUIDELINES FOR THE BILLING OFFICE TO FOLLOW WHEN WORKING WITH INDIVIDUALS WHO ARE HAVING DIFFICULTY PAYING THEIR MEDICAL BILLS. A REFERRAL IS MADE TO THE HOSPITAL'S FINANCIAL AID OFFICE AND A FINANCIAL COUNSELOR WILL HELP THE PATIENT APPLY FOR FREE OR LOW-COST INSURANCE. IF THE FINANCIAL COUNSELOR DETERMINES THAT THE PATIENT DOES NOT QUALIFY FOR LOW-COST INSURANCE, THE COUNSELOR WILL HELP THE PATIENT APPLY FOR A FINANCIAL AID DISCOUNT BASED ON INCOME LEVEL. THE HOSPITAL MAKES ITS FINANCIAL AID POLICY KNOWN TO THE PUBLIC BY PROVIDING WRITTEN INFORMATION AVAILABLE IN BOTH ENGLISH AND SPANISH, INCLUDING BROCHURES AT ALL PATIENT SERVICE AREAS, INFORMATION POSTED ON THE INTRANET AND INTERNET, AND INFORMATION SENT OUT ON PATIENTS' BILLS. THERE ARE ALSO SIGNS POSTED AT THE MAIN ENTRANCE TO THE HOSPITAL IN ENGLISH AND SPANISH ADVISING PATIENTS OF THE ROOM LOCATION FOR ASSISTANCE WITH FINANCIAL AID. 4. COMMUNITY INFORMATION: Mount Vernon is the third most populous city in Westchester County. The city is 4.4 square miles and is the 2nd most densely populated city in New York State, trailing only New York City. According to the 2017 American Community Survey, Mount Vernon has 68,671 residents and has experienced 0.4% population growth from 2000 to 2017. The city has the highest proportion of non-Hispanic black residents in Westchester County at 64% (compared to 13.5% countywide). One-third of all residents are foreign born. Additionally, it is the seat of Westchester Countys homeless services and senior services programs, housing a disproportionate number of lower-income residents. Mount Vernon is located just north of the Bronx and bordered by Pelham, Bronxville, Eastchester, and Yonkers. Mount Vernon is among the most ethnically diverse communities in Westchester County. Its population is 64.3% non-Hispanic black, 16.1% non-Hispanic white, 15.4% Hispanic, 2.0% non-Hispanic Asian and 1.9% non-Hispanic other. One-third (33%) of its residents are foreign-born. Among the foreign-born population, more people (55%) speak only English at home than Spanish (19%) and other languages (26%). The city has the second highest percentages of residents living below poverty in Westchester County. About 15% (14.8%) of the population lives below the poverty level (9.4% countywide) and the median household income is $54,573 (compared to $89,968 countywide). Twenty-percent of Mount Vernon children live below poverty; nearly twice the countywide proportion (11.7%). While Westchester County remains among the healthiest counties in New York State, several of its individual municipalities continue to have significant health gaps. Portions of lower Westchester, specifically Mount Vernon, Yonkers, New Rochelle and White Plains are hot spots for various health outcomes, such as asthma and preterm births in the County. Additionally, certain groups, such as some racial/ethnic minorities or those with less education, experience poorer health outcomes. The City of Mount Vernon has been deemed to have a geography that meets the criteria as a medically underserved area, with respect to its access to primary care services. This categorization is based on an index value that includes the infant mortality rate, the poverty rate, the percentage of elderly population and the primary care physician to population ratio. 5. PROMOTION OF COMMUNITY HEALTH: MONTEFIORE HEALTH SYSTEM, INC. IS A LEADER IN COMMUNITY HEALTH AND HAS A LONG HISTORY OF DEVELOPING INNOVATIVE APPROACHES TO CARE AND CREATING PROGRAMS TO BEST SERVE THE CHANGING NEEDS OF ITS COMMUNITY. MONTEFIORE's Office of Community & Population Health has a dedicated community educator who spearheads initiatives in the city of Mt Vernon. These events are focused on a variety of issues, ranging from chronic disease management and prevention, cancer screenings and promotion of healthy food consumption. Events range from farmers market walks, workshops in the community, walkathons, health fair and community-based health screens. The Mount Vernon Facility has focused its engagement across multiple health indicators; diabetes, breast, cervical and colorectal cancers while addressing cardiovascular disease in the older adult population. To increase screening rates for cardiovascular disease the team coordinates screening services and educational workshops to older adults at frequently occurring points of congregation, including senior centers and naturally occurring retirement communities. These workshops provide a gateway to engage the community in health programming that ensures that our work is targeted towards high needs/high impact activities. 6. AFFILIATED HEALTH CARE SYSTEM: MONTEFIORE MOUNT VERNON HOSPITAL IS AN AFFILIATE OF MONTEFIORE HEALTH SYSTEM, INC. The Health System is a leader in community and population health and has a long history of developing innovative approaches to care and tailoring programs to best serve the changing needs of its community. These include, but are not limited to the following: Community Service Plan, Community Service Strategy, Accountable Care Organization, Patient-centered medical home, disease management programs and community outreach. The integration of these innovative approaches supports Montefiore well in its provision of service to the community. 7. STATE FILING OF COMMUNITY BENEFIT REPORT: MONTEFIORE MOUNT VERNON HOSPITAL FILES A COMMUNITY SERVICE PLAN WITH THE STATE OF NEW YORK. true true false false false false false false false PHILIP O OZUAH MDPHD President & CEO (Eff 11/15/19) 0 2192717 0 3287300 0 1578318 0 17000 0 26570 0 7101905 0 0 CHRISTOPHER S PANCZNER Assistant Secretary 0 903133 0 321200 0 46034 0 17000 0 9913 0 1297280 0 0 Bentley A Ogoke MD Anesthesiologist 450322 0 0 0 1584 0 6800 0 26034 0 484740 0 0 0 BALASA PRASAD MD CHAIRMAN-ANESTHESIA 474274 0 0 0 0 0 6800 0 0 0 481074 0 0 0 FRANCIS AGBONKPOLO MD ANESTHESIOLOGIST 415083 0 0 0 1584 0 6800 0 20049 0 443516 0 0 0 Nadeem Hussain MD Psychiatrist 363094 0 0 0 541 0 6746 0 19569 0 389950 0 0 0 SUSAN GREEN-LORENZEN RN System SENIOR VP-OPERATIONS 0 1091431 0 397700 0 720761 0 17000 0 27220 0 2254112 0 0 LYNN RICHMOND Exec VP-CSO(Resigned 11/14/19) 0 1028990 0 529100 0 2060653 0 16346 0 23915 0 3659004 0 1918556 COLLEEN BLYE EXEC VP & CFO 0 1154118 0 660000 0 1032 0 698856 0 11181 0 2525187 0 0 STEVEN M SAFYER MD CEO (Resigned 11/14/19) 0 2019153 0 2082300 0 4534116 0 8170157 0 27181 0 16832907 0 0 Jaccel Kouns VP & Exc Director MMV 0 296671 0 75000 0 552 0 17000 0 29137 0 418360 0 0 Sanford Taffet MD Physician 327973 0 0 0 4326 0 6800 0 25436 0 364535 0 0 0 Schedule J, PART I, LINE 4a Steven Safyer, M.D., Chief Executive Officer and a trustee, received severance in the amount of $8,393,621 from a related organization. $239,156 of this amount was received in 2019 and is reflected in the total reported for column (B)(III) other compensation. The remainder of the severance is to be paid over the next two years and is included in the deferred compensation reported in column (C). PART I LINES 3, 4B & PART II - COLUMNS (B)(I), (II) AND (III) As it relates to Compensation from Montefiore Medicine Academic Health System, Inc. and Montefiore Health System, Inc. The Compensation Committee reviews and approves all forms of compensation and benefits provided to each executive with the assistance of a national independent compensation consulting firm. The consulting firm assists the Compensation Committee with its decision-making process to ensure executive compensation levels are reasonable and appropriate relative to those of other similar organizations. Base salaries in Column B(i) are determined based on competitive market practices for comparable positions with similar size organizations and scope of responsibilities. Bonus and incentive compensation in Column B(ii) is based on the achievement of performance goals. The executives' compensation program has a significant pay-at-risk component to ensure the alignment of pay and organizational performance. Goals are set in advance in areas such as quality of care, patient satisfaction, community services and financial performance. Compensation is at risk if the goals established by the Compensation Committee are not met. Other reportable compensation in column B(III) includes distributions from the supplemental executive retirement plan. In a manner designed to qualify for the "rebuttable presumption of reasonableness" the Compensation Committee of the Board of Trustees expressly reviewed and approved these retirement benefit arrangements for senior executives in a manner that qualified under the intermediate sanctions rules of the Federal tax law, and in recognition of (a) the executives' years of service to the organization and (b) the significant contributions to enhancing the ability of the organization to achieve its charitable mission in a manner consistent with financial solvency. Accordingly, this benefit should be viewed as applying to years of service for the organization. Pooled Supplemental Executive Retirement Plan distributions: Steven Safyer, M.D. - $3,797,607 Susan Green-Lorenzen, R.N. - $698,175 Philip O. Ozuah, MD, Ph.D - $1,420,693 Lynn Richmond - $2,040,314 ($1,918,556 of this amount was reported as accrued benefits in prior years) Supplemental Executive Retirement Plan accrued and unpaid service costs: Colleen Blye - $681,856. The officers and Key Employees listed in Part II, Column A are not employees of this filing organization, Montefiore Mount Vernon Hospital. These individuals are employed and their compensation is paid by either Montefiore Medicine Academic Health System, Inc., EIN 47-1582973, or Montefiore Health System, Inc., EIN 20-1615393. FORM 990, PART VI, SECTION A, LINE 6: MONTEFIORE HEALTH SYSTEM, INC IS THE SOLE MEMBER OF MONTEFIORE MOUNT VERNON HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A: THE BOARD OF TRUSTEES OF MONTEFIORE HEALTH SYSTEM, INC., THE SOLE MEMBER OF MONTEFIORE MOUNT VERNON HOSPITAL, HAS THE AUTHORITY TO APPOINT THE BOARD OF TRUSTEES OF MONTEFIORE MOUNT VERNON HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7B: THE BOARD OF TRUSTEES OF MONTEFIORE HEALTH SYSTEM, INC., THE SOLE MEMBER OF MONTEFIORE MOUNT VERNON HOSPITAL, HAS THE AUTHORITY TO APPROVE THE OPERATING AND CAPITAL BUDGETS OF MONTEFIORE MOUNT VERNON HOSPITAL. FORM 990, PART VI, SECTION B, LINE 11B: THE FORM 990 WAS PREPARED BY MONTEFIORE HEALTH SYSTEM'S FINANCE DEPARTMENT WITH THE ASSISTANCE OF VARIOUS DEPARTMENTS. THE FORM 990 WAS REVIEWED AND APPROVED BY THE VICE PRESIDENT FINANCE - FINANCIAL REPORTING AND THE HOSPITAL'S SENIOR LEADERSHIP TEAM INCLUDING THE CHIEF FINANCIAL OFFICER. IN ADDITION, AN INDEPENDENT ACCOUNTING FIRM WAS ENGAGED TO REVIEW THE FORM 990. UPON COMPLETION OF THE VARIOUS REVIEWS, THE FORM 990 WAS PRESENTED TO THE FINANCE COMMITTEE OF THE BOARD OF TRUSTEES FOR REVIEW AND APPROVAL. ONCE APPROVED BY THE FINANCE COMMITTEE OF THE BOARD OF TRUSTEES, THE FORM 990 WAS PROVIDED TO ALL MEMBERS OF the governing BODY before being filed. FORM 990, PART VI, SECTION B, LINE 12C: ORGANIZATION COMPLIANCE POLICY MONITORING AND ENFORCEMENT: The organization regularly and consistently monitors and enforces compliance with the disclosure policy by means of a survey developed by counsel and approved by the Montefiore Legal and Compliance Committees of the Board of Trustees. The survey is sent to all trustees, officers and key employees for completion. All survey responses are reviewed by the Compliance Officer. Any potential conflicts identified in the responses are discussed with senior management and/or the Legal and Compliance Committees of the Board of Trustees. Potential actions to be taken in response to a conflict is one or more of the following: 1)disclosure of conflict; 2)individual recusal from decisions for transactions where that individual may have a conflict; 3)request the individual to alleviate the conflict; OR 4)removal of the individual from the board of trustees. FORM 990, PART VI, SECTION B, LINE 15A & 15B: All officers and key employees are employed and paid by either Montefiore Medicine Academic Health System, Inc. or Montefiore Health System, Inc., The parent Companies of Montefiore Health Sytem, Inc. and Montefiore Mount Vernon Hospital, respectively. Montefiore Health System, Inc. is committed to ensuring that its executive compensation program adheres to the highest standards of regulatory compliance and best corporate governance. The Board of Trustees has charged the Compensation Committee of the Board (which is comprised of independent Board members with no conflicts of interest in regards to executive compensation) with making all decisions related to compensation for officers and certain key employees. All decisions made by the Compensation Committee are appropriately and timely documented in meeting minutes. The compensation committee's review process follows the Intermediate Sanctions guidelines for qualifying for the rebuttable presumption of reasonableness. The Committee retains an independent compensation consultant to assist it with this process. Compensation levels are established considering data for comparable organizations, an assessment of management performance (including the services provided to the community), and other business judegment factors, consistent with Montefiore's executive compensation philosophy. The Committee's decisions are made in the best interest of Montefiore, and are intended to ensure the recruitment and retention of key executive talent, consistent with the market practices of other not-for-profit healthcare organizations of comparable scope, mission and complexity. On an annual basis, the Committee provides the full Board of Trustees with a description of the committee's review and approval process and its decisions. FORM 990, PART VI, SECTION C, LINE 19: THE CONFLICTS OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE MADE AVAILABLE UNPON REQUEST. FORM 990, PART XI, LINE 9 The other increase in net assets of $13,200,348 was mainly due to a $13,214,504 intercompany extinguishment of debt, partially offset, by defined benefit pension and postretirement plans to be recognized in future periods ($14,156). FROM 990, PAGE 1, BOX J WEBSITE: HTTP://MONTEFIOREHEALTHSYSTEM.ORG/MOUNTVERNON MMC Corporation 111 East 210th Street Bronx NY 10467 133430322 Real Estate NY 501(C)(3) 12A TYPE I MMC true Montefiore Medical Center 111 East 210th Street Bronx NY 10467 131740114 acad med ctr NY 501(C)(3) 3 MHS true Montefiore Hosp Housing Sect II Inc 3450 Wayne Avenue Bronx NY 10467 237160641 Staff Housing NY 501(C)(2) MMC true Mosholu Preservation Corporation 3400 Reservoir Oval East Bronx NY 10467 133109387 Community Ser NY 501(C)(3) 12A TYPE I MMC true Gun Hill MRI PC 200 EAST GUNHILL ROAD BRONX NY 10467 133734486 DIAG SERVICES NY 501(C)(3) 12A TYPE I MMC true Montefiore Health System Inc 555 SOUTH BROADWAY BLDG A FL 1 TARRYTOWN NY 10591 201615393 PARENT NY 501(C)(3) 12B Type II MMAHS true MMC Residential Corp I Inc 3411 Wayne Avenue Bronx NY 10467 911943271 Staff Housing NY 501(C)(2) MMC true Schaffer Extended Care Center 16 Guion Place New Rochelle NY 10801 462929888 Nursing Home NY 501(C)(3) 3 MHS 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41 East Post Road Davis Ave White Plains NY 10601 133281507 Fundraising NY 501(C)(3) 12A Type I WPHMC true Montefiore Nyack Hospital Foundation 160 North Midland Avenue Nyack NY 10960 133245804 Fundraising NY 501(C)(3) 7 NYACK HOSP true The Winifred Masterson Burke Rehab Hosp 785 Mamaroneck Avenue White Plains NY 10605 131739937 Rehab Hosp NY 501(c)(3) 3 MHS true St Luke's Cornwall Hospital 70 Dubois Street Newburgh NY 12550 141340054 Hospital NY 501(c)(3) 3 MHS true Hudson Vista Medical PC 70 Dubois Street Newburgh NY 12550 452526738 Healthcare NY 501(c)(3) 12A Type I SLCH true Hudson Vista Physician Services PC 70 Dubois Street Newburgh NY 12550 272020746 Healthcare NY 501(c)(3) 12A Type I SLCH true St Luke's Cornwall Health System Inc 70 Dubois Street Newburgh NY 12550 223026261 Holding Comp NY 501(c)(3) 12A Type I MHS true St Luke's Cornwall Health SYSTEM Fdn 70 Dubois Street Newburgh NY 12550 223026263 Fundraising NY 501(c)(3) 7 SLCHS true Amos and Sarah Holden Home 70 Dubois 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